Human Papillomavirus, Anal Squamous Intraepithelial Lesions, and Human Immunodeficiency Virus in a Cohort of Gay Men

Cross-sectional associations between human papillomavirus (HPV), anal squamous intraepithe-lial lesions (SIL), and human immunodeficiency virus (HIV) were studied in a cohort of gay men. HPV DNA was detected by generic and type-specific polymerase chain reaction (PCR) probes and hybrid capture assay (HC). HPV virus load was estimated by HC relative light unit (RLU) ratio. HPV prevalence, number of HPV types detected, and HC RLU ratios were each greater in HIV-positive than HIV-negative participants. Further, among HIV-positive men, HC RLU ratio was inversely associated with CD4 cell count. SIL was more frequent in HIV-positive participants, particularly those with a CD4 cell count 200/mL and was positively associated with HPV. Men with a high HC RLU ratio were nearly 3 times more likely to have SIL than were those both PCR- and HC-negative. These data support that HIV augments HPV-associated anal disease in this population. Human papillomaviruses (HPV), particularly HPV-16 and that in the general population [10]. While that study could not assess the risk associated with HIV independently from-18, are causally associated with invasive cervical cancer and its precursors [1–4]. Since the squamocolumnar junction be- that associated with homosexuality, cross-sectional studies have demonstrated both an increased prevalence of anal HPVtween the rectum and anus are histologically similar to th